Talk:Lyme disease

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Too long

I've tagged this article with {{verylong}} as it is extremly large (about 91 kilobytes long). I think we need some more splitting or to delete some parts of the article. Any suggestions? --AAA! (AAAA) 12:40, 24 July 2007 (UTC)

• It is already shorter than well written Featured Articles on other controversial medical topics such as AIDS (112 kilobytes), Schizophrenia (102 kilobytes) and Asperger Syndrome (92 kilobytes).

• It is already a Wikipedia Good Article.

• By far the longest subsection is References (31 kilobytes), distantly followed by Treatment (7 kb), Diagnosis (7 kb), Advancing Immunology Research (5 kb), Epidemiology (4 kb), History (4 kb), Controversy (4 kb), Prevention (3 kb), Transmission (3 kb), and Symptoms (3 kb).

The depth and coverage of this article overall seems about right to me; it is also very well referenced with over 170 references. Many subjects in medicine are always going to be large and complicated, especially the controversial ones such as Lyme Disease.

I think this article needs a bit of careful restructuring, instead of shortening. If you strip out the references, the article is only 60 kilobytes long. I'd agree there are some sub-topics (e.g. Treatment and Diagnosis), which are perhaps covered in slightly too much detail, and could be a little shortened by summarizing and moving some content to separate in-depth articles.

The major criticism I'd make of this article is the overview at the start. It's not as readable or helpful as it could be; it would benefit from being simplified and re-written. What do you think?

--Neparis 18:04, 24 July 2007 (UTC)(Neparis)

Agree with Neparis. The "overview" as it is now, is a biology reference. There is no encyclopedic general introduction or summary. If kilobytes are the standard of article length than obviously something is very wrong with the standards. Are we squeezing articles so they fit better an sellable CDs? If that is the case I'll go back to "shovelware" CD Encyclopedias I stashed away.Cuvtixo 12:56, 17 August 2007 (UTC)

On that same note, I took out a section about "famous people possibly infected" the gist of which was that George W. Bush got bit by a tick while out for a ride a year ago. Nothing personal against Bush - it just seemed out of place in an already lengthy article. Narco 09:25, 9 August 2007 (UTC)

Some of the measures mentioned above are not an accurate measure of size. Using Dr pda (talk · contribs)'s script to measure readable prose per WP:SIZE, and looking at featured articles (AIDS is no longer a featured article):

• Lyme disease: 44 kB (6870 words)
• Schizophrenia: 46 kB (6945 words)
• Asperger syndrome: 29 kB (4395 words)
• Autism: 34 kB (5251 words)
• Tourette syndrome: 32 kB (5022 words)
• Rotavirus: 17 kB (2801 words)

Lyme disease is somewhat long, but still within the 50KB recommended guideline. More importantly, it doesn't conform to WP:MEDMOS recommended sections, here. Classification and pathophysiology are missing, and sections could be better organized to conform to MEDMOS. SandyGeorgia (Talk) 21:20, 20 June 2008 (UTC)

What is the right length?

Can we reach a consensus on what is the "right" length for this article? I posted a few thoughts, as well as a list of sections ordered by decreasing length (here). The longest section was and still is References (31 kilobytes). The Treatment section is perhaps a bit too long. Perhaps some content could be split off into a separate article? Ditto for the environmental countermeasures recently added to the Prevention section.

However, I think there are good reasons to avoid over-shortening this article. Many subjects in medicine are always going to be large and complicated, especially the controversial ones such as Lyme Disease. The Lyme Disease article is shorter than articles on other controversial medical topics such as AIDS (112 kilobytes), Schizophrenia (102 kilobytes) and Asperger Syndrome (92 kilobytes). Nonetheless this article continues to grow as other editors add even more new material, e.g. recent edits by Trees123 and 69.120.212.35. Please share your thoughts here and say which sections (if any) you think should be shortened or split off into separate articles. Neparis 15:05, 13 August 2007 (UTC)

If kilobytes are the standard of article length than obviously something is very wrong with the standards. Are we squeezing articles so they fit better an sellable CDs? If that is the case I'll go back to "shovelware" CD Encyclopedias I stashed away. Cuvtixo 12:58, 17 August 2007 (UTC)

Difficulty in Diagnosing.

Here is a lead, based on a ABC documentary, about a person who was finally diagnosed with Lyme's disease.

He was tested more than 4 times, no proof.

He was admitted to hospital emergency suffering from panic attacks, heart and lung problems without being diagnosed.

Eventually a lyme's disease specialist was able to diagnose, after so, so many tests that proved othewise.

It is important to ensure that the article suggests the "extreme" difficulty in testing.

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 15:27, 14 August 2007 (UTC)

Yes-- absolutely this article really does a disservice to many suffering patients.. Current Lyme diagnostic tests are considered to be inadequate.. They do not use band 31-- which is the Outer Surface Protein A OspA marker on the spirochete. THis is curious since OspA WAS used in the Steere/Yale/Smithkline Lyme vaccine-- meaning that it IS an identifying marker for the disease. Attorney general blumenthals investigation is looking into the possibility of collusion here and a discussion of this investigation would be useful here. ---freyfaxi

Most cases of Lyme don't answer to your characterisation. There are a lot of people with vague symptoms who will eventually have a false-positive test result to some poorly-indicated unreliable test. "Specialists" are the worst in this regard. JFW | T@lk 14:52, 17 August 2007 (UTC)

There are alot, there are some, and there are others; we do agree that 'testing' is unreliable, and 'specialists' are anything but ?

--Caesar J. B. Squitti  : Son of Maryann Rosso and Arthur Natale Squitti 03:29, 18 August 2007 (UTC)

I don't have a dog in this fight, but from a medical point of view...The OspA protein is produced while the B. burgdorferi is residing in the tick, but rapidly diminshes (even extinguishes) once the tick is exposed to warm mammalian blood. This produces a couple of problems, the first being that the vaccine is only useful for a short time (perhaps less than a few weeks) after administration. Secondly, because OspA is rapidly downregulated once inside a human host, it would not be useful for determining if there is a current infection in an animal host. (ref: Sherris 4ed. pp434-435). The only caveat to this, is that Anti-OspA antibodies do have some cross reactivity to human HLAs. Current guidelines say that the presence of EM is diagnostic, but can be followed up with IgM blot(2of3 presumptive) followed by a IgG blot(5of10 diagnostic), but the proteins that show up on these tests are also proteins found in other bacteria. I hope that helps a little. BruceD270 00:48, 9 October 2007 (UTC)

An important point that should be stressed about the vaccine is that the OspA antibody kills B. burgdorferi within the tick midgut as it feeds on the vaccinated individual's blood, before transmission of the bacteria from the tick to the human occurs (see Sherris p. 437, 4th ed). NighthawkJ 07:55, 9 October 2007 (UTC)

Lyme Funding

Lyme treatment funding is relevant to patients. Please do not delete this without a discussion. I will report administrators who delete this section without adequate discussion.. Thank you. Freyfaxi 19:27, 21 August 2007 (UTC)

Whether or not funding issues are relevant to patients is, well, irrelevant. The question is "Are funding issues encyclopedic? -- MarcoTolo 19:54, 21 August 2007 (UTC)

The Lyme Funding and Treatment Controversy section is not, at it stands, encyclopedic. In particular, the section runs afoul of WP:OR (also the no synthesis portion) since it suggests links between individual researchers and a "treatment controversy" without citing any references to support the claim of a connection - the refs mentioned only support the claim that so-and-so was funded or was appointed to X position, not the central assertion that a controversy exists (or that these individuals are associated with one). The lack of WP:RS sources to back the claims made here also raises WP:BLP issues for the individuals named. Unless these problems can be dealt with ASAP, this section needs to be pulled. -- MarcoTolo 20:08, 21 August 2007 (UTC)

Hi, MarcoTolo:

Your WP:OR, WP:SYN and NPOV critiques of the Lyme Disease Funding Controversy are flawed.

WP OR is defined as: Original research (OR) is a term used in Wikipedia to refer to UNPUBLISHED facts, arguments, concepts, statements, or theories. The term also applies to any unpublished analysis or synthesis of published material that appears to advance a position — or, in the words of Wikipedia's co-founder Jimmy Wales, would amount to a "novel narrative or historical interpretation."

FACT: The Lyme Disease Association, a nationally recognized and frequently quoted patient advocacy group publicly names a number of scientists (some included in this article) as being involved in research, funding and patent ownership conflicts of interest. By excluding LDA and ILADS' positions, this article is NPOV, and caters almost exclusively to the offensive biowar scientists in the "Steere" camp, while giving no credence to field doctors in the ILADS camp.

FACT: The President of ILADS has publicly stated that he believes Lyme Disease is a bioweapon. The systematic deletion of numerous published references in this article to Lyme bioweapons researchers, their membership in the Epidemic Intelligence Unit, and their work on anthrax, bubonic plague, tularemia and Rickettsia in this article violates NPOV and leads readers to erroneously believe that Lyme researchers have no financial or research interests in the lucrative offensive bioweapons complex.

FACT: Mention of the critically acclaimed mainstream book Lab 257 was continuously deleted to the point of vandalism. Footnotes citing mainstream papers that ran stories of Lyme disease research in BSL-3 labs are systematically deleted here. A noted Lyme activist had a widely reported showdown with Plum island oficials, and yet all mention of these conflicts is deleted and covered up here. NPOV is suffering and the article is one-sided, and damages wikipedia's reputation.

FACT: The connection between biowarfare budgets and Lyme researchers is well established in numerous online and published media reports on BSL-3 and BSL-4 labs. The thesis is also published in a well known book, Lab 257, and in the the article, "Lyme is a Biowarfare Issue" by Lyme activist Elena Cook which asserts the connection with clarity and many fotnotes. Sorry, but you can't claim that I have engaged in original research on this one-- so many articles have already been published. Omission of all mention of these PUBLISHED points of view here egregiously violates NPOV.

FACT: Attorney General Blumenthal is investigating conflicts of interest in Lyme research. The scant discussion of this case is a violation of NPOV.

FACT: There is not mention of the class action lawsuits surrounding the damaging Lymerix vaccine, and the questionable history revolving around this vaccine. There is no mention of the elimination of band 31 OspA in the diagnostic test, while it was being used in the vaccine. This fails NPOV.

Nice try but.....

This article is one of the most egregious violations of NPOV because it has thus far almost completely ignored patient groups and the Attorney General of Connecticut, who have stated clearly that they believe there is evidence of a financial, moral and research conflict of interest with respect to Lyme disease.

Failure to include these published and sourced points of view from the patient community in both ILADS, the LDA and in the wider media violates Wikipedia's sacred policy of NPOV..

You WP SYN comment is addressed by the footnote sourcing the LDA. I will be adding more footnotes, and I expect consideration.

You can't delete this information on the basis of flawed legalistic claims -- if you do, I will challenge it.

69.120.212.35 16:45, 22 August 2007 (UTC) -Freyfaxi —The preceding unsigned comment was added by 69.120.212.35 (talk) 16:48, August 22, 2007 (UTC)

First of all, thank you for providing a reference (the 2001 LDA position paper) - while I have issues with the document, it does alleviate some of my OR concerns. Secondly, please assume good faith. To address your other statements, I'll use a number list format so we can keep track of the discussion:

1.The President of ILADS has publicly stated that he believes Lyme Disease is a bioweapon. I'm assuming you're referring to Raphael Stricker - can you please provide a reference for this statement? A Google search provided many third-hand "Stricker said X" links, but no reliable source that I can find directly quotes Dr. Stricker.

2. Mention of the critically acclaimed mainstream book Lab 257 was continuously deleted to the point of vandalism. Regardless of it's level of acclaim, if the book meets the reliable source standard, I see no reason not to include a citation, provided WP:WEIGHT is considered.

3. The connection between biowarfare budgets and Lyme researchers.... Omission of all mention of these PUBLISHED points of view here egregiously violates NPOV. Not exactly. Wikipedia is an encyclopedia, not a collection of everything that has ever been published on a topic. Again, if citations meet the WP:RS criteria for inclusion (without running afoul of the Wikipedia core policies), they should be included.

4. Attorney General Blumenthal is investigating conflicts of interest in Lyme research. Okay, but again, statements like this need to be attributed to a reliable source.

5. There is not mention of the class action lawsuits... Okay, so briefly mention them (with citations, of course).

6. I will be adding more footnotes, and I expect consideration. Of course.

I will refrain from editing this section for a day or two to allow you time to provide sources for your additions. -- MarcoTolo 17:36, 22 August 2007 (UTC)

in reference to: 16:03, 5 January 2008 89.159.157.45 (Talk) (89,747 bytes) (→Controversy - The three paragraphs delete are factually incorrect and speculative, bordering paranoid.)

The controversy section contains large sections of text that are far from impartial if not factually incorrect. The paragraphs quoted below (#3-7) should be removed, as they are not neutral and irresponsible. As mentioned above, these paragraphs are in violation of Wikipedia policy due to the fact that they employ, "unpublished facts, arguments, speculation, and ideas; and contain unpublished analysis or synthesis of published material that serves to advance a single position". Many references are lacking and some that are included are misrepresented. The term “biodefense” has erroneously been replaced by “bioweapons” intentionally implying some secret sinister plot associated with the research. The tex leads the uninformed reader to believe that government funding is menacing and clandestine, when NIH (National Institutes of Health) grants are nearly the only source of funds for biomedical research. Inclusion of these paragraphs do a disservice to the readers by presenting propaganda, conspiracy suggestions bordering on ridiculous, and intentional errors as fact. See specific comments below in CAPITAL letters:

"In recent years prominent American Lyme researchers of the camp that denies, or belittles the importance of, Lyme as a chronic neurological infectious disease have received substantial federal government funding for BIODEFENSE research (WELL-KNOWN AS ONE OF THE ONLY FORMS OF FUNDING FOR INFECTIOUS DISEASE RESEARCH). For example, Alan Barbour, credited with first culturing the Lyme bacteria, and whose B31 strain became the basis of all subsequent diagnostic tests for the disease, was recently placed in charge of the multi-million dollar new BIODEFENSE research center at UCI. [105] Similarly, Jorge Benach, whose team collected the batch of ticks from which Barbour's strain was isolated, was chosen in 2004 as recipient for a $3 million BIODEFENSE research grant. [106] And Mark Klempner, author of a famous study contending that persisting symptoms in Lyme patients treated with antibiotics were unlikely due to chronic infection, was recently placed in charge of the 1.6 billion-dollar NATIONAL BIOCONTAINMENT LABORATORY complex at Boston University."

THIS NEXT PARAGRAPH MAKES NO LOGICAL SENSE, IS WHOLLY LACKING SUBSTANTIATION OR REFERENCES, AND IS SIMPLY LUDICROUS IF NOT OUTRIGHT PARANOID. AGAIN, RESEARCHERS ARE NOT WORKING ON “BIOWEAPONS” RESEARCH, RATHER “BIODEFENSE” RESEARCH. THIS TERM IS JUST AN ALL INCLUSIVE PHRASE THAT HAS BEEN USED RECENTLY TO COVER THE EMERGING INFECTIOUS DISEASE AND DEFENSE AGAINST POSSIBLE BIOLOGICAL ATTACK FIELDS – MOSTLY IN AN EFFORT TO HELP BOOST FUNDING IN INFECTIOUS DISEASE RESEARCH, AN AREA THAT HAS BEEN HURTING LATELY DUE TO BUDGET CUTS. “The selection of leading Lyme researchers for such senior posts in BIODEFENSE research, coupled with the fact that many of them have a long history of such work (REFERENCE????), which pre-dates the expansion of this field after the 2001 anthrax attacks, has fuelled accusations that Lyme disease is intimately connected with biological warfare science (REFERENCE???), and that military objectives have influenced these scientists to obfuscate the facts surrounding this disease, to the detriment of patients(REFERENCE???).”

"The unearthing, in recent years, of a number of documents referring to the study of Lyme disease in BSL-4 (Biosafety Level 4) labs, the very highest level of biocontainment which is generally reserved for airborne biowarfare organisms such as weaponised anthrax, has only served to stoke suspicion further. (An example of one such piece of evidence is the section on biocontainment in a 2003 letter from the director of a California Health Department concerning a bid for a BIODEFENSE grant.[107]" THIS LETTER CLEARLY IS JUST STATING BROADLY WHAT RESEARCH AT THE NEW REGIONAL LABORATORY WILL HELP RESEARCHERS TO PREVENT. IT IS UNFORTUNATE THAT THIS STATEMENT WAS MADE IMMEDIATELY AFTER A COMMENT ABOUT THE BSL-4 LABORATORY. THESE NEW CENTERS ARE BEING CREATED BOTH TO EXPAND THE NUMBER OF PLACES WHERE BSL-3 AND BSL-4 AGENTS CAN BE WORKED ON, AS WELL AS, OFFER CENTERS THAT FACILITATE COLLABORATION.

"Mark Klempner, Alan Barbour, Allen Steere, David Dennis, Edward McSweegan, Philip Baker, Captain Paul Mead and many others who have had a profound influence on Lyme disease diagnostic and treatment policy have a history of association with BIODEFENSE research in the past(REFERENCE???), and/or with the Epidemic Intelligence Service, founded in the 1950's as an elite biowarfare think tank." THE WAY THIS IS STATED LEADS THE READER TO THINK THAT THE EIS WAS FORMED TO MAKE WEAPONS. INSTEAD IT WAS CREATED AFTER THE KOREAN WAR BROUGHT THE THREAT OF BIOLOGICAL WARFARE TO THE ATTENTION OF THE UNITED STATES. AS A RESULT, CDC'S EPIDEMIC INTELLIGENCE SERVICE (EIS) TRAINING PROGRAM WAS STARTED TO IMPROVE OUR ABILITY TO DETECT AND IDENTIFY OUTBREAKS OF INFECTIOUS DISEASE.

"The denial, by the United Kingdom government during a parliamentary debate[108] THIS REFERENCE POINTS TO A WEBSITE IDENTIFYING LYME DISEASE RESEARCHERS IN THE UK, that research into Lyme disease had taken place during a time when the UK's top biowarfare facility Porton Down was indeed studying it, further stoked this controversy. The work at Porton Down has since been confirmed, being noted for example, by the British delegation to an international conference on bioterrorism [109]. THIS WEBSITE ONLY MENTIONS LYME DISEASE IN A SECTION DEALING WITH GIS WORK WHICH IS SEEKING TO MODEL IN COMPUTER PROGRAMS THE POSSIBLE RISK FOR VECTOR-BORNE DISEASE. THE QUOTE FROM THE REFERENCE IS, “An example of a predictive modelling study being carried out at HPA Porton Down relates to the sheep tick, which can transmit a range of vector-borne diseases, including Congo Crimean Haemorrhagic Fever, Lyme Fever, ehrlichiosis, babesiosis and tick-borne encephalitis.” THIS REFERENCE IS MISREPRESENTED IN THE WIKIPEDIA ARTICLE TEXT IN A MANNER THAT IMPLIES THAT THE AUTHOR MEANS TO SKEW THE READERS INTERPRETATION INTENTIONALLY.

I am simply trying to better Wikipedia's article on Lyme Disease by keeping it rational and impartial, and avoid it becoming a site for advertising of extreme opinions on either "side".

--Charanti^Talk 19:38, 7 January 2008 (UTC)--89.159.157.45 (talk) 19:36, 7 January 2008 (UTC)--Charanti (talk) 13:33, 7 January 2008 (UTC)

It seems that the "Lyme funding and treatment controversy" section is redundant with the "Controversy" section, and thus I suggest it be removed. --Charanti^Talk 08:57, 9 January 2008 (UTC)

The sentence about Richard Blumenthal should be retained and moved into the "Controversy" section. I agree that everything else in the "Lyme funding and treatment controversy" section should be removed. In fact, I feel that the several paragraphs decribing the connections to biowarfare/biodefense should be completed deleted from both sections. MarcoTolo's original concerns (see above) have still not been sufficiently addressed after four months of waiting. NighthawkJ (talk) 18:24, 10 January 2008 (UTC)

I think Charanti has improved the section, partly addressing MarcoTolo's concerns, but I agree there is more work to do. However, I think it is appropriate for there to be brief explanation of the connection to biodefence (not "biowarfare"), which is significant and can be properly referenced to reliable sources. - Neparis (talk) 04:30, 11 January 2008 (UTC)

I made the changes in lieu of deleting the paragraphs completely, as I observed that the paragraphs were replaced quickly when I tried that in the past. I agree that the paragraphs could/should be deleted - making there appear to be controversy about the source of some Lyme disease funding being biodefense grants seems to just be perpetuating an idea that a handful of people had that shows a general ignorance for how all infectious disease research is funded in the U.S. --Charanti^Talk 17:17, 12 January 2008 (UTC)

The other problem with devoting so much space to the Lyme funding-biodefense connection is that it gives readers the impression that it is the dominant issue in the Lyme controversies. This is far from reality. Articles in the news media about the Lyme controversies mention connections of researchers to the pharmaceutical and insurance industry, the antitrust case in Connecticut, and problems with the Lyme vaccine. However, the major figures in the Lyme wars have never mentioned anything (to the best of my knowledge) about connections of Lyme to biodefense. For these reasons, inclusion of such a lengthy description of the biodefense issue appears to violate WP:undue weight. It would be helpful to see the actual quote that Freyfaxi claims was made by the president of ILADS about B. burgdorferi being a bioweapon. NighthawkJ (talk) 19:11, 14 January 2008 (UTC)

We have waited for some time for discussion on this section. As no opposition has been encountered I have begun trimming the section. I began by removing the more slanted and unsupported parts. I still believe that the second "controversy" section should just be removed, perhaps one or two sentences could be moved from it to the first section. --Charanti^Talk 09:58, 1 February 2008 (UTC)

Undid Charanti delete. Funding details of key Lyme researchers restored to provide factual reference for opening statement. Freyfaxi (talk) 20:08, 18 February 2008 (UTC)freyfaxi

Imaging

"The average time from symptom onset to diagnosis in these patients is about 4 years due to efforts by the CDC and infectious disease community's to cover-up the illness"

where did this come from? there is no source and the info does seem a bit exotic. I reconmmend deletion i no reliable source for this information can be found. Weeddude (talk) 07:36, 17 November 2007 (UTC)

In this edit. I'm not aware of any evidence to support such a claim, but I think we should wait a while to see if other editors can provide any citations to support it. I've tagged it "citation needed". If nobody responds, it should be removed. It is interesting that the edit seems to have been reviewed by User:MarcoTolo, who did not revert it in this edit. - Neparis (talk) 00:36, 18 November 2007 (UTC)

Subclinical prevalence of Borrelia

It may be interesting to note that according to some studies, only a small percentage of people who get infected (or are at least tested positive for antibodies to the bacteria) do not seem to get any signs of Lyme disease (including myself), and that infection may thus be much more prevalent than previously thought.

I have found a lot of links to research on this topic (up to 1999) at http://www.geocities.com/HotSprings/Oasis/6455/latent-biblio.html 145.97.200.25 (talk) 14:33, 12 March 2008 (UTC)

One example of an interesting article: http://www.springerlink.com/content/gq62m5p71184014p/

Abstract A cross-sectional sero-epidemiological study was conducted on forestry workers, a high risk population for Lyme borreliosis. The prevalence of seropositive forestry workers (indirect immuno fluorescence assay) is 15.2% (n = 211). Almost 70% of participants reported a history of tick bite. Among districts, high seroprevalences were observed in Fontainebleau and Rambouillet; two sites of high risk for Lyme borreliosis. However, clinical prevalence of the disease is very low. During the investigation no active Lyme borreliosis was observed. Thus, asymptomatic infection predominates. Borrelia burgdorferi - Ile de France - Ixodes ricinus - Seroprevalence 145.97.200.25 (talk) 14:48, 12 March 2008 (UTC)

I cited a paper that makes a similar point about Swedish orienteers: PMID 9556169. It also discusses other studies where similar findings were observed in European populations. I was unable to access the article cited above since I wasn't willing to pay for it. Asymptomatic infections in U.S. populations are already described in the article. NighthawkJ (talk) 23:53, 8 April 2008 (UTC)

Interesting point, but it must be pointed out that not all ticks are infected; that there are about 3 dozen Borrelia species, and only about 1/3 of these are known to be pathogenic; and that each pathogenic species may have varieties with various degrees of virulence. And symptomatology might not occur until after 10 years past the tick bite. Therefore, high seroprevalence and low clinical manifestations should never be interpreted to mean that it is relatively safe to be bitten by a tick.Bnk wkpd (talk) 19:09, 6 June 2008 (UTC)

History of Lyme Disease

When and how was it discovered? Dan (talk) 16:11, 24 April 2008 (UTC)

There's a section on the history of Lyme disease in the article. In short, several disease manifestations of what we now call Lyme disease had been examined primarily in Europe since the 1880s, with the benefits of penicillin therapy first demonstrated in the 1940s. In the 1970s, the examination of a cluster of cases of childhood arthritis in Lyme, Connecticut, brought to the attention of authorities by two concerned mothers, eventually led to the complete description of the disease and the isolation of the bacteria. NighthawkJ (talk) 04:52, 25 April 2008 (UTC)

I was surprised to find no reference to any of these subjects here regarding the history of Lyme disease in the United States...

• Plum Island (New York) and Plum Island Animal Disease Center
• Erich Traub and Operation Paperclip

I also checked the Lyme disease controversy article.

Also interesting, the AP reported about the US gov't acknowledging Lyme disease as a biological weapon and there's no mention of that here either.[1] Corey Salzano (talk) 19:19, 29 April 2008 (UTC)

There's a lengthy discussion in the archives concerning the removal of these topics from a previous version of the Lyme disease article [2]. NighthawkJ (talk) 01:51, 1 May 2008 (UTC)

What I found was hardly a discussion about facts, but thanks for pointing me in the right direction. Corey Salzano (talk) 20:13, 16 May 2008 (UTC)

I have restored some of the information about Plum Island and the Japanese biowar research on Borrelia conducted prior to and during the Second World War. I have removed Nighthawk J's misleading edits in which he violates NPOV regulations by giving his own interpretation of the significance of Lyme scientists' biowarfare background, which he seeks to downplay massively.

In fact, his edit was completely misleading as it seeks to portray the issue as simply one of funding, distracting from the fact that a disproportionate number of scientists from the camp declaring chronic Lyme non-existent or rare, and advocating extremely narrow diagnostic criteria, also happen to possess very strong past and/or current links with research into biological weapons. Given that these same scientists characterise Lyme as an "easily-cured" somewhat trivial disease, it is remarkable that leading biowarfare scientists have devoted, and continue to devote, so much time to studying it. All these issues are highly relevant to the discussion and explain neatly why there is a controversy regarding the "Steere camp" of Lyme scientists' links with biowarfare research.

The debate regarding the use of the word "biodefense" rather than "biowarfare" is a non-issue, as most of the reearch is acknowledged to have dual-purpose potential, ie it could be used both to develop bioweapons and to defend against them. Shine a lite (talk) 17:54, 31 May 2008 (UTC)

I’m not sure which edit [[3]] of mine you are referring to. You may be referring to someone else’s edits, probably Charanti’s, who in my opinion was able to restore the section to a NPOV tone before your recent edits. Regardless of who performed the edits that you disagree with, I have problems with the new version of the passage. I won’t repeat Charanti’s concerns, which are detailed above under Talk:Lyme disease#Lyme Funding, but I will list some other concerns below.

The assertions that a disproportionate number of leading Lyme disease researchers are involved in biowarfare research are either unreferenced or improperly referenced with unreliable sources. The claim that “so many Lyme disease” researchers are members of the EIS, also unreferenced, is not credible. It would be easy to find among the many hundreds of former EIS members some who now participate in Lyme disease research.

Moreover, the definition of “biowarfare research” used here is overly broad and casts a wide net that includes basic research of any microbe that can be a potential bioweapon, even if the research is performed openly and has no direct application to creation of bioweapons. Hence by this liberalized definition, to give just one example, anyone who has ever performed any type of research on HIV would have a link to biowarfare as HIV is a potential bioweapon.

It is also misleading to present the work of the pre-WWII Japanese with the “Borrelia genus” as evidence that Lyme disease research is connected to biowarfare. The Japanese were clearly working with relapsing fever Borrelia, not Lyme disease Borrelia, which was not discovered until decades later. Additionally, B. burgdorferi was present in the United States long before Erich Traub stepped foot on Plum Island. NighthawkJ (talk) 16:27, 2 June 2008 (UTC)

I removed the Japanese/Erich Traub/Plum Island passage. NighthawkJ (talk) 16:45, 4 June 2008 (UTC)

Open Letter to Nighthawk J

I am sharing this discussion with members of the Lyme community via online forums such as Lyme Net, because those most entitled to know all essential and relevant facts about this disease are, after all, those who have had their lives ruined by it.

That said, let’s deal with the issues. This debate has been very long, and it would be unreasonable to expect people, especially Lyme patients, so many of whom suffer cognitive impairment, to concentrate on dozens of issues at once. I will therefore reply, for now, only to the points in your above comment.

You state that I have not provided proper references for my assertion that that “a disproportionate number of leading Lyme disease researchers are involved in biowarfare research”. My original Wikipedia paragraph gave examples, with proper references, of the biowarfare background of four highly important figures in Lyme disease science – Mark Klempner (whose 2001 paper is consistently used by doctors and insurance companies as the basis for denial of treatment for chronic Lyme); Alan Barbour, considered co-discoverer of the causative agent of Lyme; Allen Steere, so-called discoverer of the disease in the 1970’s and the leading proponent of “Steere camp” thought; and Jorge Benach. In addition one reference led to an article I wrote called “Lyme Disease is a Biowarfare Issue”. While you may not be happy at me referencing my own article, nevertheless that article contains several more references supporting the same point – ie that a disproportionate number of the most important Steere camp Lyme researchers have a background in biowarfare. They are all solid references and can be found at the website of NY radio presenter Dave Emory on http://ftrsupplemental.blogspot.com/2007/02/history-of-lyme-disease-as-bioweapon.html .

The Wikipedia Lyme article is already very long and I didn’t think it necessary to add a lengthy list of examples; however, as you have implied that my evidence is not substantial enough, I am adding two more leading figures in the modern history of Lyme medicine, Edward McSweegan and Phillip Baker, both of whom have served as Lyme Programme Officers at NIH and who therefore had a massive influence on diagnostic, prevention and treatment policies. Both have a strong biowarfare background and I have provided high-quality references regarding this.

If you require more examples, please let me know.

You also stated that:

“The claim that “so many Lyme disease” researchers are members of the EIS, also unreferenced, is not credible. It would be easy to find among the many hundreds of former EIS members some who now participate in Lyme disease research.”

First to recap – the CDC’s Epidemic Intelligence Service was set up during the Cold War, to conduct what, at the time, was publicly and unashamedly admitted to be offensive biowarfare research.

If you examine your two statements above, Nighthawk J, you will see that they contradict each other somewhat. In the first, you are alleging there are not many Lyme researchers who are also involved with the EIS. In the second, you are stating that it would be easy to find some Lyme researchers among graduates of the EIS.

So, I’m not clear what you are trying to say. Are you saying that you think the proportion of Steere camp Lyme researchers with a background in the EIS is very small? If so, what percentage would you consider small?

If you are trying to say that the correlation is meaningless because there are many hundreds of “former” EIS members, then you are wrong here too.

The Steere camp advise that Lyme is “hard to catch” and “easily cured” with a short course of antibiotics. Most recently they advise us that chronic Lyme does not even exist. They have alleged that serious neurological sequelae are extremely rare. Why then should America’s most highly trained infectious disease specialists, the EIS, waste their precious time on it?

Scientists like Klempner, Benach and Barbour, who have been placed at the head of biowarfare research (funded by millions to over a billion dollars) are presumably some of the best brains in the US as regards infectious disease. Why then would such individuals have devoted, and continue to devote, hours and hours of their precious time to a “hard-to-catch”, “easily cured” disease? We would not expect experts in biowarfare to be spending a major part of their careers studying athlete’s foot, for example. So why Lyme?

According to CDC itself : “Currently, 60 to 80 people are selected annually for coveted EIS posts.” www.cdc.gov/eis; http://www.cdc.gov/od/oc/media/pressrel/r010720.htm So, as I have said, this is a ***small, elite force***. If Lyme was truly “hard-to-catch”, “easily-cured” etc, it would be remarkable that even one member of such an elite force would want to specialise in it, much less many. Do the world’s most highly skilled surgeons spend their time removing ingrown toenails?

Incidentally, your word “former” to describe EIS officers is misplaced. Where is the evidence that those Lyme researchers who are publicly known to have been trained by EIS have “left” and no longer retain any links, obligations or responsibilities to it? Instead, common sense, and the evidence, indicates the opposite. Allen Steere, for example, downplayed the significance of his EIS membership during the 1970’s, and told the media that he only joined to dodge the Vietnam draft. Yet three decades later, he was still deeply involved enough to be helping to organise an EIS gala event. The militarily sensitive nature of the work makes it highly unlikely that scientists could simply leave this elite infectious disease unit, cut off all ties, and not retain any obligations to their senior officers within it.

You state: “Moreover, the definition of “biowarfare research” used here is overly broad and casts a wide net that includes basic research of any microbe that can be a potential bioweapon…”

Why do you say that? The involvement of Klempner and Barbour is at the highest level, ie they are ***heads** of RCE’s , which are biowarfare super-labs set up in the US in the aftermath of 9-11. Long before 9-11, Klempner studied ways of increasing the virulence of plague, and Barbour studied anthrax. (see refs in footnotes to my article at www.lyme-rage.info/bwsept06.html) Benach studies tularemia. (see, for example, his published study at http://www.jimmunol.org/cgi/content/abstract/171/5/2563) Do you consider research on plague, anthrax and tularemia to be “basic research on any microbe”? These are some of the most important and most feared bioweapons known to science.

Likewise, of the two most recent NIH Programme Officers in charge of Lyme disease, both have a background in biowarfare. Phillip Baker is a specialist in anthrax, and Edward McSweegan has worked, and still works, in the field of recruiting senior biowarfare scientists from the former Soviet – clearly top-level work. While with the EIS, Lyme “discoverer” Allen Steere studied Aspergillus flavus, the fungus that produces deadly biowar agent aflatoxin, of which, according to UNSCOM, Saddam Hussein stockpiled huge quantities prior to the first Gulf War. (Christopher J. Davis,Johns Hopkins University Center for Civilian Biodefense Studies, quoted in Emerging Infectious Diseases: ftp://ftp.cdc.gov/pub/EID/vol5no4/ascii/vol5no4.txt )

So clearly, the Lyme researchers’ involvement with the EIS or “biodefense” was never limited to “basic research of any microbe” potentially useful in war, as you say, but instead included some of the most deadly agents known to mankind.

If you feel these examples are insufficient for you, I can provide more.

Nighthawk J, you removed information about Japanese WW2 experimentation with Borrelia genus microbes, saying that this was irrelevant because “The Japanese were clearly working with relapsing fever Borrelia, not Lyme disease Borrelia, which was not discovered until decades later.”

First of all, the very fact that leading Lyme researchers like Alan Barbour have devoted hundreds of hours to studying relapsing fever, and have written articles outlining the parallels between this and Borrelia burgdorferi, shows that relapsing fever Borrelia are very much relevant.

Second, while there is proof that the Japanese worked on relapsing fever borrelia, you cannot state that they did not work with Lyme disease borrelia, because most of the details of their work was concealed from the public after the war. It is now known that the US government protected leading biological warfare scientists from the notorious Japanese Unit 731 from prosecution for crimes against humanity. Their knowledge and expertise was recruited for American use, and as a result most of their research came under the aegis of (classified) American military science. So, unless you happen to be an American or Japanese biowarfare scientist yourself , with access to the relevant classified material, you are not in a position to say exactly which Borrelia species were studied, or not studied, by the Japanese.

You state that Lyme borrelia were “not discovered until decades later”. Several manifestations of Lyme disease , for example ACA, have been recognised since the late nineteenth century. Therefore, in theory, Lyme borrelia organisms could have been isolated for study long before even WW2. Biowarfare agents such as glanders were used in the First World War and crude forms of biowarfare have been practised for thousands of years.

To say that WW2 biowarfare experimentation with relapsing fever borrelia is irrelevant to Lyme borrelia because the latter only become identified to civilian medicine in the 1980’s is like saying that knowledge on retroviruses acquired prior to the 80’s should be ignored by AIDS scientists, because AIDS was not identified until the 80’s. It makes no sense. Clearly in studying a new organism scientists would look at those organisms biologically closest to it. And in fact Lyme researchers often cast their net even wider than Borrelia genus, when studying Lyme. Researchers frequently refer to the characteristics of the spirochetes in general, obviously a much wider grouping which includes the agents of syphilis, gingival infections, Weil’s disease, and so on.

Finally, for some years it has been known that Lyme could be caused by many strains of borrelia other than B. burgdorferi. Recent research has shown that there are Borrelia which cause an illness identical to Lyme, which are genetically closer to Relapsing fever borrelia, than to the burgdorferi group, altogether. (Again, see www.lyme-rage.info/bwsept06.html for details and references.) This lends weight to those who believe that Lyme should be seen above all as a “borreliosis”, much like other borrelioses – serious, multi-system in nature, capable of infecting the nervous system, and of “persistence in the eye and brain”, as military doctor Jay Sanford wrote in the 1970’s – another point you, Nighthawk J, removed from the Lyme article.

In view of the above, your deletion of my information about Plum island and Erich Traub is misplaced too. The fact that a study indicated the presence of one strain of Borrelia burgdorferi in the US, long before Nazi bioweaponeer Traub was involved with tick research on Plum Island, does not mean that his, or Plum Island’s, involvement is therefore irrelevant. Does the existence of various natural strains of anthrax in American soil long ago indicate that anthrax is therefore unrelated to biowarfare?

Elena Cook (Wiki name “Shine-a-lite”)Shine a lite (talk) —Preceding comment was added at 13:56, 12 June 2008 (UTC)

I deleted the biowarfare allegations. This kind of nonsense has no place on Wikipedia and violates like a whole laundry list of Wikipedia policies especially WP:BLP since some of these scientists are still alive. Please do not try to add this back in. There are many Internet forums where it would be appreciated and I encourage you to go there. RetroS1mone talk 13:41, 18 June 2008 (UTC)

I deleted the biowarfare allegations. This kind of nonsense has no place on Wikipedia and violates like a whole laundry list of Wikipedia policies especially WP:BLP since some of these scientists are still alive. Please do not try to add this back in. There are many Internet forums where it would be appreciated and I encourage you to go there. RetroS1mone talk 13:41, 18 June 2008 (UTC)

Nighthawk J, I have restored the word "chronicum" in "erythema chronicum migrans". That was the name used by the medical establishment for nearly a century, and even used initially by Steere himself, until a political decision was made to obfuscate the chronic nature of Lyme. By the 1990's virtually all Steere camp authors had dropped the word "chronicum".

Nighthawk J, the rash was given that name, and had its name maintained for nearly a century, for only one reason - because doctors observed the persistence of the rash. It's not rocket science.

RetroS1mone, I have deleted all your edits, which range from vandalism to the insertion of dangerous medical misinformation to libel. Your wholesale disregard for the harm you are potentially causing to patients who might read this material is reminiscent of the style of Dr John Nowakowski, who was eventually convicted of libel for his anonymous internet activities.

I am sharing the details of what you have done with the Lyme community via internet forums such as Lyme Net, just as I have done with Nighthawk J's similar malicious edits.

You removed information I added, which informed people that the EM rash occurs in less than half of cases. This is highly important information. A person recently bitten by a tick, feeling ill but lacking the "classic" rash, could make a life-saving decision to seek medical treatment as a result of reading that information.

Instead you inserted a quote alleging that EM is found in 90% of infected patients. This figure has no factual basis, as it derives from old studies, some written by Steere, in which the ***very criteria for the definition*** of "infected patient" , in most cases, was the presence of an EM rash! Pure circular reasoning, in other words.

Your excuse for removing my statement was that my source (ILADS) is "not a reliable source".

ILADS is an association of doctors and allied health professionals, nearly all of whom have extensive clinical experience in treating Lyme. They have the support of tens of thousands of patients - clear proof that they are competent in their field. What better indicator is there of physician competence in a modern society, than the continuing loyalty and admiration of tens of thousands of patients?

How then can you allege they ILADS are not a reliable source?! This is a flagrqant violation of Wikipedia's "NPOV" (neutral point of view policy".

You edited a paragraph stating that the reliability of serology for diagnostic purposes remains controversial, replacing it with this:

"These tests are sufficiently reliable to support diagnoses."

Once again, a blatant violation of "NPOV". The reliability of the antibody tests is so controversial that scientists from BOTH camps have commented on the need for improved diagnostic methods.

While those in the Steere camp generally claim, publicly anyway, that existing serology can rule out Lyme, privately they hold patents in which they explicitly state that the genetic material, technique etc being patented is intended to address the problem of the ***currently unreliable tests***. They mention problems not only with specificity but also with sensitivity. I am happy to provide examples of this if you require it.

You have removed reliably sourced evidence criticising the Klempner study without any grounds for doing so, other than your own bias.

You have removed an entire paragraph, which showed a very balanced point of view, providing information about both opposing camps, and replaced it with this biased remark:

"Disagreement has arisen in the medical community over the existence and definition of a condition known to proponents of its diagnosis as "chronic Lyme." This condition includes several different patient groups, according to investigators of the Ad Hoc International Lyme Disease Group publishing in the New England Journal of Medicine'"

You then quote at length from only ONE camp, ie the Steere camp, (represented by the self-appointed International Ad Hoc Lyme Group).

You have removed this factual paragraph:-

"However ILADS has accused AAN of simply repackaging the IDSA guidelines as three coauthors of the new guideline, including the lead author, were also coauthors of the IDSA Lyme guideline. There is significant disagreement with this guideline."

-and replaced it with an accusation that the ILADS policy is to diagnose Lyme disease in "patients with a well-defined illness that has nothing to do with Borrelia". This is a baseless and libellous statement against an organisation of professionals.

You have compounded the libellous allegation mentioned , with this unscientific and offensive allegation :

"ILADS advocates extended courses of antibiotics, lasting for months, years, or indefinitely, for what it calls chronic Lyme patients. ILADS also advocates for insurance companies to pay their members to administer long-term antibiotic treatments, despite a complete lack of evidence of efficacy."

Where is the evidence that any ILADS doctor has written a prescription for antibiotics "indefinitely"? Further, why have you ignored peer-reviewed evidence, for example the recent Fallon study, documenting efficacy of repeated courses of antibiotics in ameliorating symptoms in chronic Lyme?

You have added material alleging that patients have been treated with dangerous bismuth compounds and with malaria (to induce fever, an early-20th century treatment for spirochetal diseases). How many people do you believe have been treated by these methods? While there are charlatans in every medical arena, the number of Lyme patients who have died of malaria, or bismuth poisoning can probably be counted on the fingers of one hand, with several fingers left over.

Those who have died of complications of misdiagnosed or inadequately treated Lyme, on the other hand, are uncountable, as no epidemiology exists, but likely add up to a staggering toll. Fatal outcomes from Lyme include third-degree heart block, stroke-like sequelae, MS and ALS-like syndromes, perinatal mortality of children born to infected mothers, road accidents due to fatigue and/or lack of concentration at the wheel, violent encounters/accidents due to neuropsychiatric illness, and Lyme-related suicides.

Further, recent studies by researchers such as MacDonald and Miklossy indicate that a proportion of Alzheimers cases may be due to Lyme. This could add hundreds of thousands more deaths to the figure.

You have removed the entire section on Lyme controversy, containing information on Blumenthal's findings that the 2006 IDSA Lyme guidelines were authored by a panel riddled with financial conflicts of interest, and containing much factual and relevant information documenting links between Steere camp scientists and biowarfare establishment. Instead, you replaced all that important information with this:

"When the Infectious Diseases Society of America (IDSA) issued new guidelines for Lyme diagnosis in 2006, recommending actual evidence of Lyme before diagnosis and treatment, the ILADS and allied chronic Lyme advocacy organizations quickly condemned the guidelines. Connecticut Attorney General Richard Blumenthal, who had received awards from chronic Lyme advocacy groups…began a probe into the IDSA panel responsible for the guidelines, putatively on anti-trust grounds. ...Although Blumenthal alleged conflicts of interest on the part of IDSA, he declined to name the allegedly conflicted panelists or detail what he considered their conflict to be. The IDSA panel responded by stating they had been wrongly "accused of profiting financially by recommending to not treat with unnecessary and prolonged courses of antibiotics,"..."

The fact that someone of the standing of Ct. Attorney General alleged financial conflict of interest, coupled with the fact that the IDSA responded by agreeing to set up a brand new panel to review the original guidelines, is an indication that financial conflict of interest was clearly present.

Indeed some of the 2006 IDSA Lyme panel members have very openly revealed their conflicts of interest. For example Raymond Dattwyler directs a biotech company developing recombinant Lyme antigens, which it has incorporated into a bioweapons vaccine against Plague.

Which brings us back to the biowarfare issue. This is arguably the greatest conflict of interest of all , with very many of the Steere camp's most prominent figures involved. You have accused me of libelling "living scientists". I have provided solid references for all my assertions regarding Steere camp researchers and biowarfare science. I challenge you to show me one example where I have accused even ONE scientist, living or dead, of being linked to biowarfare research ***without any factual basis***.

Elena Cook ("Shine-a-lite" on Wikipedia)Shine a lite (talk)

Retros1mone,

I am replying to your post by interspersing my responses in capital letters.

1. 1. 1. 1. Elena Cook (username "Shine a lite" on Wikipedia)

Elena Cook/Shine a lite,

Did you change your name recently? I am new to this but I looked at the edit history of this article, there is an editor "Freyfaxi" who writes like you and says the same stuff until February and also goes by "Elena Cook" on other websites.

I AM NOT FREYFAXI AND WHILE I KNOW SHE HAS POSTED MY MATERIAL ON NUMEROUS WEBSITES, I AM NOT AWARE THAT SHE HAS IMPERSONATED ME. I WOULD BE VERY SURPRISED IF SHE HAS.

In answer to your questions, I will say this once,

• The ILADS website is a self-published source.

It is kind of acceptable if your reporting what they say but not a RS for other information. An essay by the ILADS secretary on the ILADS website and a position statement by the ILADS secretary and past president Stricker in a low impact journal does not support the statement there are two equal standards of care for chronic lyme a condition most scientists and doctors dispute. You could say, "Two ILADS members claim there are two standards of care in the medical community" but not much more.

ONCE AGAIN, YOU ARE OBSCURING THE TRUTH. AS CAN BE SEEN FROM MY VERY LONG POST ABOVE, I ACCUSED YOU OF MALICIOUSLY REMOVING WHOLE SECTIONS FROM THE LYME ARTICLE, AS WELL AS MANY KEY SENTENCES. THE VERY MANY FACTS YOU REMOVED WERE NOT SOURCED BY JUST ONE REFERENCE, BUT MANY, INCLUDING NUMEROUS ARTICLES IN THE PEER-REVIEWED MEDICAL LITERATURE.

AS FAR AS QUOTING THE ILADS WEBSITE, THAT MAY HAVE BEEN DONE TO SUPPORT ONE OR TWO STATMENTS. DOZENS OF OTHER RELIABLE SOURCES SUPPORTED THE REST, AS CAN BE SEEN FROM THE REFERENCE LIST NOW I HAVE REVERTED YOUR EDITS.

HOWEVER, THE ILADS WEBSITE ITSELF MEETS THE CRITERIA OF WIKIPEDIA'S RELIABLE SOURCES POLICY, FROM WHICH I QUOTE BELOW:

"ACADEMIC AND PEER-REVIEWED PUBLICATIONS ARE HIGHLY VALUED AND USUALLY THE MOST RELIABLE SOURCES IN AREAS WHERE THEY ARE AVAILABLE, SUCH AS HISTORY, MEDICINE AND SCIENCE, ALTHOUGH SOME MATERIAL MAY BE OUTDATED BY MORE RECENT RESEARCH, OR CONTROVERSIAL IN THE SENSE THAT THERE ARE ALTERNATIVE THEORIES. MATERIAL FROM RELIABLE NON-ACADEMIC SOURCES MAY ALSO BE USED IN THESE AREAS, PARTICULARLY IF THEY ARE RESPECTED MAINSTREAM PUBLICATIONS. WIKIPEDIA ARTICLES SHOULD STRIVE TO COVER ALL MAJOR AND SIGNIFICANT-MINORITY SCHOLARLY INTERPRETATIONS ON TOPICS FOR WHICH SCHOLARLY SOURCES EXIST, AND ALL MAJOR AND SIGNIFICANT-MINORITY VIEWS THAT HAVE BEEN PUBLISHED IN OTHER RELIABLE SOURCES..."

• The fact that an Attorney General alleged conflict of interest means he alleged conflict of interest. The case was settled with no findings of antitrust violation.

THE ATTRONEY GENERAL HIMSELF FOUND SERIOUS DEFICIENCIES. I HAVE ALREADY QUOTED THE OFFICIAL STATEMENT FROM HIS OFFICE REGARDING THIS.

Potential conflicts of interest by IDSA members are disclosed on papers they write.

I WOULD NOT BE SO QUICK TO STATE THAT THE IDSA 2006 LYME PANEL MEMBERS DISCLOSED ***ALL*** THEIR CONFLICTS OF INTEREST AT THE TIME, IF I WERE YOU. HAVE YOU EVIDENCE OF THAT?

Compare to ILADS members who don't mention their organization wants to treat patients with no evidence of infection with months or years of antibiotics and insurance companies should pay for the unproven treatments.

THIS IS A LIBELLOUS STATEMENT.

• A BSL-4 lab is a lab to work with dangerous pathogens. They don't have to be bioweapons. Work on a vaccine or on anthrax or other pathogens is not necessarily bioweapons research.

ARE YOU EXPECTING US TO ACCEPT THAT RESEARCHERS IN THE HIGHEST SECURITY LABS IN THE WORLD, IN THE AFTERMATH OF 2001, ARE STUDYING ANTHRAX BECAUSE THEY ARE CONCERNED FOR THE SAFETY OF THE FOUR OR FIVE FARMERS IN THE US WHO STILL SORT WOOL BY HAND, AND ARE CONSEQUENTLY AT RISK OF NINETEENTH-CENTURY-STYLE CUTANEOUS ANTHRAX?

The CDC unit you refer to as an offensive bioweapons unit was a surveillance unit to detect emerging diseases.

I HAVE ALREADY EXPLAINED THAT THE PHRASE "EMERGING DISEASES" IS A CATCH-ALL TERM, USED TO ENCOMPASS BOTH BIOWEAPONS AND UNEXPLAINED EPIDEMICS OF INFECTIOUS DISEASE ARISING FROM CAUSES OTHER THAN BIOWARFARE ATTACKS OR ESCAPES. OFTEN, IN THE INITIAL STAGES, IT IS IMPOSSIBLE TO KNOW WHICH ONE IS CONCERNED.

IN FACT, THE EXAMPLES IN THE ARTICLE AND IN THE REFERENCES LEFT REFER TO ***SEVERAL*** DIFFERENT BSL-4 LABS STUDYING LYME, NOT JUST ONE.

• Your bioweapons charges are based on two relevant sources,

SIMPLY NOT TRUE. I'VE PASTED IN THE EXISTING REFS FROM THE SECTION IN THE ARTICLE THAT DISCUSSES BIOWARFARE BELOW. THERE ARE FAR MORE THAN TWO.

THEY INCLUDE A LEADING NATIONAL NEWSPAPER; THE NIH; OFFICIAL INFO FROM BOSTON UNIVERSITY AND UNIV OF CALIFORNIA RE THEIR ASSOCIATED BIOWARFARE LABS (DIRECTED BY LEADING STEERITE RESEARCHERS MARK KLEMPNER AND ALAN BARBOUR RESPECTIVELY); THE NEW YORK STATE OFFICE OF SCIENCE, TECHNOLOGY AND ACADEMIC RESEARCH; AND A LETTER FROM THE HEAD OF A CALIFORNIA PUBLIC HEALTH DEPARTMENT.

ALL OF THESE SOURCES EASILY MEET THE "RELIABLE SOURCE" CRITERIA OF WIKIPEDIA.

a book where the author raises the possibility of pathogens excaping Plum Island, and without any direct evidence as reviews say. 

THIS BOOK HAS BEEN ENDORSED BY TWO FORMER GOVERNORS, MARIO CUOMO AND LOWELL P. WEICKER.

IT BEARS 29 PAGES OF SOURCE REFERENCES, VIRTUALLY ALL OF WHICH WOULD BE CONSIDERED RELIABLE SOURCES BY WIKIPEDIA'S CRITERIA.

MANY OF THE SOURCES ARE DECLASSIFIED US GOVT DOCUMENTS. THOUGH THE US GOVERNMENT MAINTAINED FOR DECADES THAT THE LAB WAS A CIVILIAN FACILITY, THE AUTHOR HIMSELF , AS HE EXPLAINS IN HIS NOTE "TO THE READER", WAS BARRED FURTHER VISITS ON THE GROUNDS OF "NATIONAL SECURITY".

The second source is a radio talk show that mentions something you wrote under the pseudonym "Elena Cook." That is not a RS.

MY ARTICLE IS ONLY ONE REFERENCE AMONG MANY IN THE SECTION DISCUSSING BIOWARFARE, AND I ONLY MENTIONED IT HERE IN ORDER TO DIRECT READERS TO ITS REFERENCE LIST, WHICH CONTAINS DOZENS MORE SOURCES, SUPPORTING FURTHER STATEMENTS LINKING BIOWARFARE SCIENCE WITH THE PROBLEMS SURROUNDING LYME MEDICINE.

NEARLY ALL THE SOURCES QUOTED IN MY ARTICLE THAT I AM REFERRING TO MEET THE CRITERIA OF WIKIPEDIA'S RS POLICY TOO. I INVITE YOU TO HAVE A LOOK IF YOU DOUBT THAT.

The book is also not a RS except to say, "Michael Carroll, in Lab 257, raises the possibility that Lyme could be an escaped pathogen from Plum Island."

The section on bioweapons allegations has no place on wikipedia without better sources (a better source), I said once before and I will not say again. Wikidia is not a soapbox to indulge one's fantasies about government conspiracies unless those fantasies coincide with information in reliable sources.

YOU ARE BREAKING WIKIPEDIA'S POLICY ON BEHAVIOUR BY ADDRESSING ME IN SUCH AN ABUSIVE WAY. THE WELL-SOURCED ARGUMENTS I AND OTHERS HAVE INSERTED ON THIS ISSUE ARE IN NO WAY "FANTASY".

THAT YOU HAVE TO RESORT TO SUCH TALK, AND TO CLOUDING THE ISSUES AGAIN AND AGAIN AS ALREADY DESCRIBED, INDICATES HOW BANKRUPT YOUR OWN ARGUMENTS ARE.

LIST OF REFERENCES SUPPORTING THE BIOWARFARE MATERIAL IN WIKIPEDIA'S LYME ARTICLE AS OF 22 JUNE 2008:

CARROLL, MICHAEL “LAB 257- THE DISTURBING STORY OF THE GOVERNMENT'S SECRET GERM LABORATORY”, HARPER COLLINS 2004 ^ WASHINGTON POST JANUARY 22, 2005 ^ BUMC FACULTY WEBPAGE ^ UCI MEDICAL CENTRE, JUNE 1, 2005 ^ NYSTAR NEWS PUBLICATION OF THE NEW YORK STATE OFFICE OF SCIENCE, TECHNOLOGY AND ACADEMIC RESEARCH, AUGUST 2004 ^ "LYME DISEASE IS BIOWARFARE ISSUE" BY ELENA COOK, PUBLISHED/DISCUSSED BY DAVE EMORY, WFMU TALK SHOW HOST, 2007 HTTP://FTRSUPPLEMENTAL.BLOGSPOT.COM/2007/02/HISTORY-OF-LYME-DISEASE-AS-BIOWEAPON.HTML ^ HTTP://WWW.YOLOCOUNTY.ORG/ORG/BOS/AGENDAS/2003/012803/46.PDF LETTER FROM HEAD OF YOLO COUNTY HEALTH DEPARTMENT, CALIFORNIA ^ HTTP://WWW.CTLYMEDISEASE.ORG ^ HTTP://WWW3.NIAID.NIH.GOV/NEWS/EVENTS/BALTICWORKSHOPSERIES/PARTICIPANTS.HTM#MCSWEEGAN ^ HTTP://WWW.NIH.GOV/NEWS/PR/APR2006/NIAID-23.HTM

RetroS1mone talk 14:45, 21 June 2008 (UTC)

npov problem

Chronic lyme disease as stated in current version is not accepted by majority of medical authorities. A rewrite to include the presence of a standard, and a small minority of dissenters would be appropriate.User:Palmd001 04:18, 25 May 2008 (UTC)

That so-called "standard" was largely taken from the 2006 IDSA guidelines, now up for review after Ct Attorney General Blumenthal found the panel which composed them had serious conflicts of interest which biased their judgment. I am amazed this fact is absent from the article. "Blumenthal's findings include the following:

• The IDSA failed to conduct a conflicts of interest review for any of the panelists prior to their appointment to the 2006 Lyme disease guideline panel;
• Subsequent disclosures demonstrate that several of the 2006 Lyme disease panelists had conflicts of interest;
• The IDSA failed to follow its own procedures for appointing the 2006 panel chairman and members, enabling the chairman, who held a bias regarding the existence of chronic Lyme, to handpick a likeminded panel without scrutiny by or formal approval of the IDSA's oversight committee;
• The IDSA's 2000 and 2006 Lyme disease panels refused to accept or meaningfully consider information regarding the existence of chronic Lyme disease, once removing a panelist from the 2000 panel who dissented from the group's position on chronic Lyme disease to achieve "consensus";
• The IDSA blocked appointment of scientists and physicians with divergent views on chronic Lyme who sought to serve on the 2006 guidelines panel by informing them that the panel was fully staffed, even though it was later expanded;
• The IDSA portrayed another medical association's Lyme disease guidelines as corroborating its own when it knew that the two panels shared several authors, including the chairmen of both groups, and were working on guidelines at the same time. In allowing its panelists to serve on both groups at the same time, IDSA violated its own conflicts of interest policy."
http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284 Shine a lite (talk) 18:46, 26 May 2008 (UTC)

Let's be perfectly clear. IDSA is a org with 8000 members, then you have AAN. The CDC backs them. There is the Ad Hoc International Lyme Disease Group. There is the medical literature. ILADS is a few hundred docs and nurses who profit by giving people with unexplained symptoms months or years of very expensive antibiotics with no evidence they have an infection and no evidence the antibiotics work if they did. And they want insurance companies to pay for them. Talk about a conflict of interest! I have no idea if chronic lyme is real or not and I really don't care too much except for the people who suffer from symptoms. I do know the medical community is almost unanimous on chronic lyme and the literature has gotten more clear in the past year, and that's what counts by Wikipedia. I re wrote the major ILADS slant to reflect consensus in science and medicine. You can say there is evenly divided opinion, doesn't make it so. —Preceding unsigned comment added by RetroS1mone (talk • contribs) 13:38, 18 June 2008 (UTC)

Article issues

I suggest the following cleanup (the copyedit and citation issues are the most urgent, but general cleanup is needed as well):

• Classification and pathophysiology sections missing, and better conformance with WP:MEDMOS
• The article is not well written. As a first example, because the Classification section is missing, the article's first section (Symptoms) dives right in to Lyme at a place that doesn't make sense. Copyedit needs and redundancies are easily spotted: ... After several months, untreated or inadequately treated patients may go on to develop severe ... Here's an example of an undefined, unlinked term and a poorly written sentence: Symptoms most often occur from May through September because the nymphal stage of the tick is responsible for most cases. (The reader hasn't been told yet about tick stages, there's no link, and the sentence is awkwardly worded.) Basic copyedit errors are found, like: ... can be fatal.[81][82][83][84]The first CDC ...
• The WP:LEAD is not an adequate summary of the article.
• Scare quotes are used throughout, including in section headings
• Just looking at the first section (Symptoms) reveals far too much uncited text. Second section, same. As I find time, I may start tagging cites needed. Citation tags throughout. Also uncited, weasly, unattributed opinion, such as:
  • The position of many in the medical community is that only the last group ...
• and missing citations: ^ Cite error: Invalid ref tag; no text was provided for refs named Marques ...
• A lost of WP:MOS cleanup is needed, some samples:
  • WP:MOSDATE ... according to a June, 2008 report ...
  • Wikilinking attention needed, example: ... face (called facial or "Bell's palsy) ... and notice the stray quote there, indicating the need for a copyedit
  • Incorrect punctuation on some image captions, see WP:MOS#Images
  • Sporadic incorrect footnote placement, WP:FN
  • WP:MOSNUM and WP:DASH ... for 3 weeks. The researchers noted the clinical outcome of said patients should not be evaluated at the completion of intravenous antibiotic treatment but rather 6-12 months
  • WP:PUNC, logical punctuation errors
• Removal of ticks section breaches WP:NOT
• There is an external link farm that should be pruned by linking to Dmoz, see WP:EL.

In addition to the POV concerns raised on talk, the article needs serious attention to a cleanup, rewrite and copyedit. SandyGeorgia (Talk) 21:49, 20 June 2008 (UTC)

Erythema migrans vs. erythema chronicum migrans

Shine-a-lite (Elena Cook), if you look at the recent reviews of Lyme disease in high-quality journals (in NEJM or Lancet, for example) you will see that "erythema chronicum migrans" is not used. In fact the term “erythema migrans” is used to describe the rash in both the IDSA and ILADS guidelines. ILADS calls the rash “erythema migrans” on their website (see “Basic Information about Lyme Disease”). NighthawkJ (talk) 18:37, 21 June 2008 (UTC)

Nighthawk J, I have already stated that I am aware that the word "chronicum" has been dropped in recent years from many publications on Lyme, and I have explained that this is the result of a political decision to downplay or indeed deny the potential of Lyme to manifest itself as a chronic illness, rather than the sudden discovery that a century of dermatologists were wrong.

The rash bore the name Erythema ***chronicum*** migrans for nearly a century because that is what physicians observed - a rash that persisted.

Many of the papers considered landmark works by your own camp used the term. For example, early papers by Steere himself (eg "Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum."). The name can also be found in the famous 1982 paper by Burgdorfer and Barbour "Lyme disease-a tick-borne spirochetosis?".

Clearly the natural course of a disease, untreated, does not alter, whatever the fashion and politics of later times. The fact that ILADS have fallen into line with what has become a convention among US researchers is not specially significant.

One reason many in the ILADS camp may have been prone to accept the name change is because on prompt treatment with modern antibiotics, the rash may disappear. This does NOT, however, necessarily imply that the patient is now cured, or that systemic dissemination has been prevented.

“Untreated, the rash persists for 2 to 3 weeks, but the duration may EVEN LAST 14 MONTHS (caps mine}. Eighty percent of patients may have only one episode of erythema migrans, while 20% may have recurrent episodes. Multiple lesions may occur in 40% of patients and may be an important marker for hematogenous dissemination…”

(source: "Dermatology: Just the Facts", Francisco A. Kerdel, Francisco Jimenez-Acosta, Pub McGraw Hill Professional 2003 p34 ISBN:0071391436)

The importance of the name "chronicum" used to describe the EM rash by generations of dermatologists in Europe is this: it indicates the bacteria's potential for resistance to the onslaught of the body's innate and acquired immune response.

And indeed a Pubmed search reveals that the original name is still widely used by researchers in Europe and other non-American countries.

Elena Cook Shine a lite (talk) 08:11, 22 June 2008 (UTC)

in naming things, we follow current authoritative practice, which for infective diseases generally means the latest practice at CDC or major english language medical journals, which almost always amounts to the same thing. DGG (talk) 22:30, 23 June 2008 (UTC)

Elena, it would be easier for others to follow discussions if you thread your responses per WP:TP. SandyGeorgia (Talk) 16:55, 24 June 2008 (UTC)

Merging Lyme disease controversy

The Lyme disease controversy is a classic "POV fork". POV forks fare very poorly once they are discovered by the larger Wikipedia community. Please begin discussing how to merge it into the Lyme disease article. Phlegm Rooster (talk) 19:12, 22 June 2008 (UTC)

yep, a classic fork. Seems to be used for the presentation of specific research papers in more detail than appropriate. DGG (talk) 19:30, 22 June 2008 (UTC)

I would suggest that we improve the rather disastrous "Controversy" section of this article, bring it into line with policy, and at that point the POV fork will be superfluous. Of course, if there's simply too much well-sourced and policy-compliant material for a subsection here, we can spread it out to a sub-article. MastCell ^Talk 17:28, 24 June 2008 (UTC)

And for that matter unless good citations state there is a controversy why have a controversy section or article? Good minority opinion should be embeded right into the article. I've seen too many articles about Contorversy or that have a controversy section and in reality it is all or mostly fringe opinion.--scuro (talk) 18:02, 24 June 2008 (UTC)

Respectfully, I disagree. The Lyme controversy is a massive debate and deserves its own article. I consider it an article spinout. Of course both sides of the debate must be appropriately represented in that article to maintain an overall neutral viewpoint. Axl (talk) 07:12, 26 June 2008 (UTC)

The Lyme debate is not particularly massive; instead, the proponents of chronic Lyme syndrome are remarkably vocal. The established medical and scientific groups have already come down on the "this does not exist" side, so the controversy is largely pushed by the proponents. This is not to say that the controversy should not be featured here, because it should. This is also not to say that the proponents are wrong; they may be right. However, given WP policies (particularly WP:UNDUE), the controversy should really be explained concisely here. The controversy page is far from concise, and aspects such as the large table comparing the medical view with the advocates' view in a line-by-line fashion should be cut entirely. Antelan^talk 13:33, 26 June 2008 (UTC)

I guess I'm on the fence. I agree with Antelan that most expert bodies are in agreement about the lack of effectiveness of long-term antibiotics and so forth. On the other hand, the political controversy is real and notable, with articles in the New York Times on harassment of a Lyme disease expert, the unprecedented investigation of the IDSA by the Connecticut Attorney General, and so forth. I think the best approach is to focus on this article and improve the controversy section to the point where it features reliable secondary sources and appropriate WP:WEIGHT. At that point, if the section is large, unwieldy, and dense, it can be spun out to the "controversy" fork. Trying to improve the two articles in parallel is probably going to be an exercise in futility, and the only way to know for sure if a spinout article is warranted is to fix up the controversy section to Wikipedia's standards and see what we've got. MastCell ^Talk 16:02, 26 June 2008 (UTC)

I do not agree that there is not a notable scientific controversy in addition to the political one. I agree that the views of ILADS should not be given equal weight as those of the IDSA, AAN, CDC, etc, but they should be given 'some' weight. I am bothered that the scientific views of ILADS and other advocacy groups have been completely expunged from the article, except for single sentences in the lead and the Controversy section that only state that they disagree with the medical establishment. (ILADS is not even mentioned in the article anymore.) Their scientific viewpoints are taken seriously enough that they were recently summarized in a article written by past ILADS president Raphael Stricker in the IDSA journal ‘Clinical Infectious Diseases’ pmid 17578772. I feel that the issues raised in his article, especially those that describe 'why' he disagrees with the medical establishment’s view on chronic Lyme, should be briefly mentioned somewhere. NighthawkJ (talk) 17:30, 26 June 2008 (UTC)

Yes, I think the 2007 point/counterpoint articles you mention (PMID 17578771 and PMID 17578772) could be useful sources to describe the core of the debate. This isn't the finished product by any means, so we can certainly expand the coverage of the debate somewhat. I definitely prefer to use these sources rather than advocacy websites. MastCell ^Talk 23:17, 26 June 2008 (UTC)

I dont care one way or other on merge but PLEASE somebody delete the table on the controversy article it is very misleading to put the mainstream views beside the fringe views and especially when the mainstream is after the fringe view. Only sources for the fringe views are ILADS web site and by ILADS written opinion articels. RetroS1mone talk 23:20, 28 June 2008 (UTC)

• The controversy is notable on its own, so I think it can have its own article. I've removed my tag on the controversy article, but can't here. Obviously the current theme of the controversy article must be about the controversy, such as the character assassination, political lobbying, etc. The point-by-point "refutation" of the points in contention is OR, and has to go. Phlegm Rooster (talk) 00:26, 1 July 2008 (UTC)

I was asked to have a look

by User:Shine a lite. I'm more than a little disturbed by some of the editing that I have been seeing here. I recognize there's a controversy here, and that both sides must be presented fairly. The general practice at Wikipedia is to consider that the official position of qualified government agencies as likely to represent the consensus, absent a clear agreement in the pertinent profession that they are likely to be wrong. We also do not go into extensive clinical detail in presenting the primary results of research studies, but give the conclusions as they are discussed by authoritative review sources. Not all peer-reviewed sources are equal, and the leading medical review journals and general journals of established importance have much greater weight as a reliable source than journals connected with a particular organisation that represents only a portion of specialists. We also strongly discount conspiracy theories as likely to be fringe, and treat them rather briefly, giving a reference or two for those who may want to inquire further, unless of course these theories seem to be substantially discussed by 3rd party independent reliable published sources, print or online (but not blogs or press releases), where "independent" means independent of those who have promulgated them. But in all this, we do not attempt to hide that there is a controversy, and we do not attempt to decide which side is right. We present the available material in terms that educated general readers can understand, and expect that they will draw conclusions for themselves. At this point I am confining myself to general principles, and have no immediate intention to do any editing myself, at least not just right now. There seem to be various accusations of COI, & personally, what I find helps such situations is a frank statement of what they are by the people involved, not by their opponents--though of course this is not required -- & any attempt to insert the names of pseudonymous editors is very strongly against policy. For the record, I'm acting as an editor, not an admin. I am doing one admin action right now, though--there seems to have been a burst of ip vandalism, and I'm semi-protecting against its continuation. I don't think it will inhibit discussion. DGG (talk) 19:58, 22 June 2008 (UTC)

DGG, first I wish to clear something up. The other editors have been addressing Shine a lite by her name because she herself revealed it on this page.

So where do we start? I'm a little confused about how you want the COI issues described to you. Are you asking each editor to disclose his/her own COI? NighthawkJ (talk) 05:19, 24 June 2008 (UTC)

I agree with everything DGG is saying, and I was asked to have a look at this article by User:SandyGeorgia in response to a decline in its quality which resulted in delisting as a Good Article. There are multiple issues which need to be addressed, but editing needs to flow from an understanding of Wikipedia's policies (particularly those on verifiability and appropriate sourcing, original research and synthesis, and undue weight). Having seen the word "censorship" already tossed around, it's also important to realize that Wikipedia is not a soapbox nor a venue to Right Great Wrongs. We need to accurately and proportionately summarize the state of knowledge on this topic, relying on sources with a reputation for accuracy and fact-checking. If we start there, rather than from the perspective that Wikipedia is a great venue to get the word out about the Evil Lyme Conspiracy, we should be fine regardless of who's who. MastCell ^Talk 17:27, 24 June 2008 (UTC)

I came to this article because my mom thought she might have it and was struck by the controversy section. I agree with what Mastcell and DGG state.--scuro (talk) 18:05, 24 June 2008 (UTC)

DGG, please would you point me to the Wikipedia page which states that the site-wide policy is to rely on information from "official position of qualified government agencies" or US government agencies, in particular. I was not aware that this was a requirement.

Second, you state that the only exception to this rule is where there is "clear agreement in the pertinent profession that they are likely to be wrong". In medicine and public health, this is a contradiction in terms. Doctors and health promotion workers look to government agencies for guidance. It is highly unlikely, if not impossible, that a situation would arise where the medical profession was solidly united around a certain issue, and the governmental health agencies in the country concerned held the opposite view.

What sometimes occurs, is that a minority of scientists discover something new, face widespread criticism and even ridicule from the establishment which is challenged by their findings, and attempts by that establishment, including the public health agencies, to downgrade, ignore or even suppress evidence-based work.

We saw something similar years ago with the pioneering researchers who linked Helicobacter pylori with peptic ulcer. Their work was for a long time sidelined , so that the etiology continued to remain unknown, with vague references to stress, caffeine etc as the predisposing factors.

Today, thanks to those pioneers' persistence, the role of bacterial infection in this disease is widely acknowledged, and those who in the past would have suffered severe morbidity from this disease, or even died from haemorrhagic complications, are often cured in a few weeks.

The majority of "POV"-violating edits in this article are being made by editors who are from the Steere camp, ie the camp of Lyme medicine which is presently backed by US government agencies.

While trying to access this site today I was presented with an appeal for funds for the Wikipedia project. The ad presented me with this quote: "Imagine a world in which every single person on the planet is given free access to the sum of all human knowledge. — J. Wales, Founder of Wikipedia"

"The sum of all human knowledge" does not equate with "only that human knowledge that the US government wishes the public to know."

In medicine, you are dealing with real human lives, real human suffering. The standard is evidence-based medicine and the scientific method - not whether or not the US government supports a given research paper.

20:10, 26 June 2008 (UTC)

• Part of the above comment has been redacted for WP:BLP reasons. Jehochman ^Talk 21:41, 26 June 2008 (UTC)

Most of the above post is simply misinformed, but the final coda is a clear violation of Wikipedia's policy on material dealing with living people. Specifically, you are alleging that a specific researcher threatened you with death. If this is the case, then by all means pursue the appropriate legal recourse, but making such an unsubstantiated and unsubstantiatable allegation on Wikipedia is a quick way to get your account blocked from editing. I'm going to ask you to remove it. MastCell ^Talk 21:20, 26 June 2008 (UTC)

29th June 2008

I was disappointed to see that the Lyme Disease page on Wikipedia has been completely rewritten with a straight pro-IDSA line. Dissenting opinion is scorned, or completely ignored. The Blumenthal judgement, with all its criticism of IDSA for excluding dissenting scientific opinion, is totally distorted. This bias is not in the spirit of Wikipedia, and something needs to be done to correct this imbalance. First I might ask, how did one side in the debate to get a stranglehold on this page, and what can be done about it? —Preceding unsigned comment added by Foundinkualalumpur (talk • contribs) 10:56, 29 June 2008 (UTC)

Biowarfare

I'm going to look at the issue of biowarfare allegations as a first step here (see this edit). This section on biowarfare is textbook original synthesis. It relies on a series of mined factoids about individual researchers to advance the editorial belief that Lyme disease is tied to biowarfare. The statement "A disproportionate number of scientists involved in Lyme treatment and diagnostic testing policy in the United States have a well publicized history in biodefense research" is a classic. Disproportionate? Let's start by collecting specific sources which discuss the alleged link between Lyme disease and biological warfare here on the talk page. We can then determine what these sources actually say, as well as judge their reliability according to Wikipedia's definition of the term. This material as currently written has no place in this article or anywhere on Wikipedia, so let's take a step back and go to the sources. MastCell ^Talk 17:35, 24 June 2008 (UTC)

I agree.--scuro (talk) 17:59, 24 June 2008 (UTC)

Far from "original synthesis", what you have is a collection of ***facts*** which, taken together, substantiate the theory that Lyme disease science has been influenced by its status as a biowarfare issue.

Specific sources that discuss the "alleged link"? Well, where do we begin. Why not begin with Raymond Dattwyler's recent patent for a vaccine based on recombinant Lyme bacteria Outer Surface Protein A plus Yersinia pestis, the etiological agent of Plague? Dattwyler, incidentally, is the director of Biopeptides Inc, a biotech firm handsomely funded by the US federal government. He is also one of the small group of authors of the IDSA 2006 Lyme guidelines, covered extensively in the article. The Guidelines are hotly in dispute and were most recently condemned by Connecticut Attorney General Richard Blumenthal for violating conflict-of-interest principles. IDSA has now promised to review them using a new panel which will be subject to vetting for financial conflcit of interest.

Those editors here keen to advance the "Steere camp" point of view and censor all others, continually claim that the Attorney General's action was unjustified and that no conflict of interest was present.

Is Dattwyler's directorship of a biotech corporation focusing on Plague and Lyme (in the one organism, no less!) not a conflict of interest, from both a financial and a military point of view?

Shine a lite (talk) 20:24, 26 June 2008 (UTC) Elena Cook

You said, "Far from "original synthesis", what you have is a collection of ***facts*** which, taken together, substantiate the theory that Lyme disease science has been influenced by its status as a biowarfare issue." Taking a collection of facts and creating a unified theory therefrom is at the heart of synthesis, which is not appropriate for WP. If someone else has done this synthesis for us verifiably in an independent source, this material may be fit for inclusion in WP. If, furthermore, it is considered of mainstream importance and is not just a push from the fringe, then it may merit a section. If not, it might belong in an article about the person to whom it is pertinent, or might not belong here at all. Antelan^talk 20:50, 26 June 2008 (UTC)

Yes. Additionally, this is not Conspiracypedia, nor a place to Right Great Wrongs. Aside from the fact that Shine a lite's comments are a borderline violation of the living-persons policy, her post provides a textbook description of improper synthesis, as Antelan has noted. This is problematic, because it suggests that she either has not read or has not understood this fundamental cornerstone of Wikipedia. I'm not here to advance what is being labeled the "Steere camp view", but I do insist on the proper representation of appropriate sources. Really, there's enough overheated and poorly fact-checked material on this topic on the Internet already. Let's try to write an encyclopedia article here. MastCell ^Talk 21:14, 26 June 2008 (UTC)

further steps

Mast Cell asked me to have a look, & I generally agree with the edits he's been doing so far. Personally, i would have chosen to integrate the material on the controversy rather than continue it as a separate article, but the other way is justified also. The biowarfare stuff can be dealt with if it turns out there's actually any material. The main remaining thing is to edit some of the medical research material at the end and reduce the number of references--they tend to accumulate unnecessarily because the non-consensus side adds whatever it can find, and the mainstream retaliates in kind. Lead references and key recent reviews are sufficient--but not everyone agrees with my view here, for I'd make this objection to a lot of the biology and medicine articles--I think the referencing of them reflects to much the style of a science graduate textbook, not a general encyclopedia. Great things, good science and medical texttbooks with full referencing, but i dont see what the purpose at Wikipedia. DGG (talk) 22:29, 24 June 2008 (UTC)

I'm with you - I'd like to integrate the controversy article here. There is no need for two articles: if we actually pare it down to what is reliably sourced, I think we can handle it in one article. The controversy article will also be extremely difficult to maintain in terms of encyclopedic quality and NPOV, based on what I've seen of editing issues here recently. I agree about cutting down the refs and have made a start; there are also a number of duplicate refs (multiple cites to the same paper) which can be consolidated. In general terms, I think medical articles are best served with an overview grounded in reliable reviews, textbooks, expert bodies, etc, with support from selected primary journal articles. I'm open to seeing some of the more insistent editors produce actual reliable sources on the biowarfare angle, but so far all I've seen there is edit-warring and accusations of censorship, which is disheartening. MastCell ^Talk 18:38, 25 June 2008 (UTC)

DGG, you say you agree with the edits by Mast Cell, who apparently contacted you for help. But in fact his history of editing here, to anyone knowledgeable about Lyme Disease medical literature and controversies, shows blatant bias and violation of NPOV. To take just a few examples, he has removed a section presenting both points of view on the advisability of long-term antibiotic treatment and replaced it with one emphasising the views of the Steere camp as expressed by the 2006 IDSA Lyme committee, whilst deleting information pointing out that IDSA has now been forced to create a new committee whose members will be vetted for financial conflicts of interest. This occurred following an unprecedented investigation by the Attorney General in Connecticut, a hyperendemic Lyme disease area, who found flagrant conflict of interest among the IDSA panel members.

Another example is his inclusion of a highly biased piece in the NY Times caricaturing the Lyme patients' movement as dangerous criminals, "stalking" Dr Allen Steere. Lyme patients exercising en masse their democratic rights to protest at the suffering and negligence they have received from health services as a result of Steere's influence on Lyme medicine is not "stalking".

In addition, there are many examples of hounding and harassment of doctors and scientists on our side. In the 1990's the NIH Lyme Programme officer, a staunch supporter of the Steere camp, committed such flagrant harassment of the leader of the largest patients' campaign of the time that he was dismissed from his post. If we are going to include these issues, in the name of balance, Mast Cell should have mentioned that. In addition there are innumerable examples of doctors and researchers on our side of the dispute being harassed and persecuted because they do not support an arbitrary three-week cut-off in antibiotic treatment, regardless of the patient's condition, or do not accept the validity of serology tests whose validity has been called into question by umpteen peer-reviewed studies.

I don't have time at the moment to list all the many other NPOV violations he has committed, but if you take the time to research some of his references, you will see that all his work is about censoring what you are calling the "non-consensus" view in favour of the US government-promoted view. It is only "non-consensus" because the most powerful government in the world has thrown its weight behind the opposite camp, for reasons that become clear when you read the sections on biowarfare controversy, which Mast Cell and the other Steere camp editors present here consistently censor from this encyclopedia.

Shine a lite (talk) 06:26, 27 June 2008 (UTC) Elena Cook

I'm confident that anyone reviewing our respective contribution histories on Wikipedia will draw their own conclusions. That's the beauty of this place. For the record, I'm not part of the "Steere camp", and had not even heard of him till I came across the New York Times Magazine article detailing the campaign of harassment he experienced. I have no axe to grind with regard to Lyme disease, either here or in real life, though I suppose I do have an issue with the overall quality, accuracy, and reliability of medical information on this particular high-profile website. I will happily stand accused of replacing unsourced allegations and conspiracism with material from the New York Times. MastCell ^Talk 06:36, 28 June 2008 (UTC)

EM prevalence in Lyme

Harrison's says it's 80%. Apparently the other source said 50%. This is why I left it double sourced and said 50-80%. I'm fine with that, or I'm fine with going with just Harrison's and saying 80%. Any preferences? Antelan^talk 19:10, 25 June 2008 (UTC)

I would prefer to go with Harrison's, as a leading internal medicine textbook, rather than ILADS, which is essentially an advocacy group for a particular view of Lyme disease. MastCell ^Talk 19:52, 25 June 2008 (UTC)

Sounds medically appropriate. I'll make the change. Antelan^talk 19:54, 25 June 2008 (UTC)

Quality of external links

I've pruned quite a few external links. The following is interesting reading: PMID 15626946. These authors examined the quality of info on Lyme disease on 19 websites. For those without full-text access to Table 1, sites determined to contain significant inaccuracies included:

• www.igenex.com
• www.ilads.org
• www.lyme.org
• www.lymealliance.org
• www.lymedisease.org
• www.lymediseaseassociation.org
• www.lymeinfo.net
• www.lymenet.org
• www.lymesite.com

In fact, the authors found that having the word "lyme" in your domain name was a strong predictor that your site contained inaccurate info. Reliable sites included: www.acponline.org, www.fda.gov, www.cdc.gov, www.aldf.org, www.healingwell.org, www.hopkins-arthritis.org, www.intelihealth.org, www.kidshealth.org, and www.webmd.com. In order to keep Wikipedia in the latter (accurate) category, we might want to take this into account when deciding what sort of sources to use for the article, not to mention which external links are appropriate. MastCell ^Talk 23:11, 25 June 2008 (UTC)

Actual content issues

I'm getting the sense that there's an unwillingness on the part of some editors to discuss the actual content of this article as it relates to Wikipedia's policies, coupled with a readiness to revert. The only talk page discussion I've seen from Shine a lite (talk · contribs) accompanying her reverts has been unproductive accusation, conspiracism, and personal attacks. Let's change that. Here are a handful of issues with the content that Shine a lite (talk · contribs) continues to reinsert without discussion:

• Published studies involving non-randomized surveys of physicians in endemic areas found physicians evenly split in their views, with the majority recognizing seronegative Lyme disease, and roughly half prescribing extended courses of antibiotics for chronic Lyme disease, suggesting that there is much disagreement and confusion on this topic. This is misleading and irrelevant. The two cited sources are from 1994 and 1996, long before the randomized controlled trials demonstrating the ineffectiveness of antibiotics. If you asked a bunch of docs in 1984 whether they thought HIV caused AIDS, you might find them evenly split, but there have been a few new findings since then. Likewise, there has been a huge amount of new evidence, and expert guidelines, since 1994/1996. This needs to go, because it's dated and creates a misleading impression.
• The biowarfare stuff remains a textbook case of improper synthesis and inappropriate conspiracism, but I've noted those objections elsewhere on the talk page.
• The policy on undue weight mandates that we represent material in proportion to its acceptance among experts in the field. It is trivial to demonstrate, via reliable sources, that the view of the CDC, IDSA, AAN, etc is a majority view and that of ILADS is a fringe/minoritarian view. This needs to be clearer; the edits by Shine a lite (talk · contribs) inappropriately place these two views on even footing when they demonstrably are not in the real world.
• Again, Harrison's Principles of Internal Medicine is a reliable source. A page from the ILADS website is not equally reliable by Wikipedia's definition, and so these should not be juxtaposed as if they are equally weighty viewpoints.
• The presentation of the Blumenthal investigation is markedly one-sided. It would be most appropriate to include the press releases from Blumenthal and that from the IDSA as dueling views on the settlement of the investigation, but to rely on independent sources to provide context. I've done this in my summary of the topic, but Shine a lite's material accepts Blumenthal's press release as the last word, which is misleading.
• This isn't a hit list where you catalog the names of the "Steere camp", throw in a few insinuations that they're biowarfare specialists, and move on. At this point, WP:BLP is required reading for Shine a lite (talk · contribs).

Comments? MastCell ^Talk 21:49, 26 June 2008 (UTC)

The core of my sentiment is this: this is a topic that has entered the medical mainstream. There are dissenting views, but these are of low medical importance. They are important enough to be mentioned, but not important enough to be played off as on par with or even significant challenges to the mainstream. Antelan^talk 22:30, 26 June 2008 (UTC)

Agree; a very brief mention is warranted, nothing more, per WP:UNDUE. (One or two sentences at most.) SandyGeorgia (Talk) 23:04, 26 June 2008 (UTC)

Agree in general, though I would give the medical dissidents somewhat more scope than SandyGeorgia-- perhaps one or two paragraphs, as it does represent a significant minority. . As for the conspiracy theory, it serves well as the epitome of small splinter views not worth considering. I wasn't in general that there are views on subject not even worth mentioning, but this example has convinced me otherwise. DGG (talk) 23:42, 26 June 2008 (UTC)

I agree that the biowarfare issues should not be included. However, for the reasons I stated above, I believe that the “alternative” medical view should be given more weight, perhaps the 1-2 paragraphs suggested by DGG. NighthawkJ (talk) 00:03, 27 June 2008 (UTC)

I agree that the controversy and fallout thereof merit a paragraph or two, but I do not agree that the actual views espoused by proponents of chronic Lyme should be a large part of these paragraphs. Antelan^talk 00:07, 27 June 2008 (UTC)

I don’t think the actual views of chronic Lyme proponents should be dismissed too much. Their position is being acknowledged and addressed in the medical literature. As mentioned before, their scientific position on the controversy was recently summarized by the past ILADS president in a high-impact journal (PMID 17578772) (as part of a point-counterpoint set of articles). Another example is the peer-reviewed article (PMID 17044928) criticizing the Klempner 2001 study. This paper was written by the current ILADS president and was briefly addressed in a recent review of post-Lyme syndrome (PMID 18452806). Hence I feel their actual views should be described, perhaps in a single paragraph, as long as it is made clear that those views are in the minority. NighthawkJ (talk) 03:18, 27 June 2008 (UTC)

I did not intend to dismiss due weight discussion of chronic Lyme; my one or two sentences was in reference to the bio warfare conspiracy theories. SandyGeorgia (Talk) 03:24, 27 June 2008 (UTC)

Contradiction ?

These two sections appear to contradict each other. SandyGeorgia (Talk) 01:51, 27 June 2008 (UTC)

Ecology

The risk of acquiring Lyme disease does not depend on the existence of a local deer population, as is commonly assumed. New research suggests that eliminating deer from smaller areas (less than 2.5 ha or 6 acres) may in fact lead to an increase in tick density and the rise of "tick-borne disease hotspots".

Management of host animals

Lyme and all other deer-tick-borne diseases can be prevented on a regional level by reducing the deer population that the ticks depend on for reproductive success. This has been demonstrated in the communities of Monhegan, Maine and in Mumford Cove, Connecticut. The black-legged or deer tick (Ixodes scapularis) depends on the white-tailed deer for successful reproduction.

For example, in the US, it is suggested that by reducing the deer population back to healthy levels of 8 to 10 per square mile (from the current levels of 60 or more deer per square mile in the areas of the country with the highest Lyme disease rates), the tick numbers can be brought down to levels too low to spread Lyme and other tick-borne diseases.

• The first one claims that deer don't give Lyme disease back to ticks, and are therefore "dilution hosts". The above text is largely copyvio, by the way. The authors note that if deer are reduced on a very local scale, the ticks will wander around, and feed on rodents, behaviors conducive to disease transmission. The scale is so local as to be relevant only in the suburbs, and does not contradict the landscape scale argument in the second passage. Phlegm Rooster (talk) 06:56, 27 June 2008 (UTC)

Pathophysiology

I changed the section title “Advancing immunology research” to “Pathophysiology,” as some of the material in this section could be included under this new heading. I also split the “Inflammation” subsection into “Lyme arthritis” and “Lyme neuroborreliosis” to indicate which manifestation of Lyme disease is being discussed. This entire section obviously needs a lot more work, maybe a complete rewrite, but I thought this would get things started. NighthawkJ (talk) 03:37, 27 June 2008 (UTC)

I started to reorder the sections per WP:MEDMOS#Sections, but decided it might be premature, and the flow might be off, but you might want to look at that. SandyGeorgia (Talk) 03:40, 27 June 2008 (UTC)

Recruiting ?

I saw mention of a Lyme forum in an edit summary; do we need to add a {{recruiting}} template to the top of this talk page? SandyGeorgia (Talk) 15:22, 27 June 2008 (UTC)

See here, there is another thread there but I've lost where it is for the moment. --Allemandtando (talk) 15:33, 27 June 2008 (UTC

ah here --Allemandtando (talk) 15:36, 27 June 2008 (UTC)

Sigh - I did register at the forum yesterday with the intention that I would explain further wikipedia policies and the best way to engage with other editors. I was hoping I could head off further problems - sadly I was banned before I made a single post (I guess because I used my name here there). --Allemandtando (talk) 14:04, 28 June 2008 (UTC)

It's interesting context for the constant allegations of censorship and invocation of free speech here, though. MastCell ^Talk 19:36, 28 June 2008 (UTC)

Exclusion of compilation of literature on persistance of spirochetes in vivo

I was surprised to see that my link to Joanne Rubel's careful academic literature compilation on the evidence for spirochetes persisting in vivo in humans and animal models for Lyme was deleted. This report meets the academic criteria expected and deserves to be put 'out there'. It is unfortunate that we see another attempt by one side to muzzle all debate. This is not in the spirit of Wikipedia. Here is the link by the way, for those who are interested: http://www.lymeinfo.net/lymefiles.html --Foundinkualalumpur (talk) 05:34, 30 June 2008 (UTC)

You must be referring to your dead link that was deleted; I suspect you'll find that more careful editing and adherance to Wiki policies and guidelines will lead to less frustration in editing. SandyGeorgia (Talk) 05:41, 30 June 2008 (UTC)

lymeinfo.net has been explicitly named as a purveyor of inaccurate information on Lyme disease; see PMID 15626946. It is certainly arguable that it violates our external links guideline by promoting information which is unverified or misleading. In any case, the last thing this article needs is a greater quantity of iffy external links. Let's improve the actual article. MastCell ^Talk 05:45, 30 June 2008 (UTC)

Talk:Lyme disease#Quality of external links. SandyGeorgia (Talk) 05:50, 30 June 2008 (UTC)

I should have linked to the individual pdf documents.. Joanne Rubel's referencing work is essentially beyond dispute even if some other parts of Lyme Info are dubious. I think it better that I start adding in the source literature references individually to the Wikipedia page instead. This will add to the already-bloated references section, but I can see it is necessary. I'll add them in over the coming weeks.--Foundinkualalumpur (talk) 00:07, 1 July 2008 (UTC)

This is one of her published papers (and the only one in PubMed), being in Polish it isn't much use to us. BJ^Talk 01:35, 1 July 2008 (UTC)

Only one article on that page is PubMed indexed ??? hmmmmm ... that says a lot. Please see WP:FCDW/June 30, 2008, this week's Dispatch, by the way. SandyGeorgia (Talk) 02:02, 1 July 2008 (UTC)

I took a look at the pdf documents this user recommendended, and the cited literature is perfectly respectable. Evidently the way to go is to link in the literature references to the page individually. F.Y.I. Joanne Rubel is not a Lyme researcher, and has never claimed to be, but the quality of her compilation speaks for itself. Evidently though, linked the literature citations into the main discussion is the way to do it. --Wanaqueling (talk) 04:26, 1 July 2008 (UTC).